In a former life I was once a lowly junior doctor working in a hospital in St Albans. During one weekend while on-call, a good friend asked me if I would see her dad who was complaining of a painful toe. My unofficial patient, a charming gentleman from the Emerald Isle, turned out to be suffering from a classic case of gout in the ball of his foot. Apart from doling out painkillers, I felt some dietary advice was in order. My knowledge of nutritional matters was practically non-existent in those days, but one thing I did know was that alcohol is a common instigator of gouty attacks. Accordingly, I advised a cutting back on the hard stuff. Later that day, I was delighted and also very amused to receive thanks for my medical attentions in the form of a bottle of Bushmills Irish whiskey.

While advice to limit alcohol is stock advice for sufferers of gout, the condition may be amenable to other nutritional approaches. Generally, gout sufferers are advised to reduce their intake of dietary elements known as purines found in foods such as meat, seafood, fish, beans and lentils. Within the body, purines can be broken down into a substance known as urate, excessive amounts of which can crystallise out in the joints to give rise to the exquisitely painful condition known as gout. However, while a low-purine diet is oft-used strategy in gout, its usefulness is limited by the fact that the majority of purines in the body do not come from the diet, but are made naturally in the body.

In recent years, a novel dietary approach to gout has come out of the fact that the majority of sufferers have been found to have signs of a condition known as insulin resistance syndrome (IRS). Believed to be a potential precursor of both heart disease and diabetes, IRS is characterised by a constellation of bodily imbalances that include excess weight (characteristically congregated around the middle of the body) and high levels of the unhealthy blood fats cholesterol and triglyceride. IRS is likely to have a number of underlying factors, one of which seems to be the over-consumption of sugar and refined carbohydrates in the modern-day diet.

In one study, the potential benefits of a carbohydrate-restricted was tested in a group of middle-aged male gout sufferers. In addition to limiting foods such as bread, potatoes, rice and pasta, the subject were also instructed to emphasise healthy fats in the form of olive oil, nuts and fish in their diets. After 16 weeks, the men enjoyed a lowering in their levels of cholesterol and triglyceride, and lost an average of 12 lbs to boot. Although this diet did not limit purine-rich foods, it nonetheless led to a significant lowering of urate levels, and a reduction in the number of gouty attacks. It seems cutting back on the carbs not only helps combat IRS, but gout too.

One folk remedy for gout is the fruit of the cherry tree. In a study published earlier this year, cherry-eating was found to bring down blood levels of urate. Other research has found that consuming half a pound of this fruit each day can help keep gout attacks at bay. While those prone to gout might like to have their fill of cherries while they are in season, I regret to report that similar benefits are unlikely to be had from cherry brandy.

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